Monday, 11 August 2014

EBOLA:  Scavenger  of  humans

The purpose of this article is to inform my readers with as much information that I can obtain about this terrible disease.
The Ebola virus belongs to the filovirus family of diseases and it is comprised of five distinct species: Zaïre, Sudan, Côte d’Ivoire, Bundibugyo and Reston. Zaïre, Sudan and Bundibugyo species have been associated with the recent large Ebola haemorrhagic fever.

Viral haemorrhagic fevers (VHF) are characterized by fever and bleeding disorders and all can progress to high fever, shock and death in a great many cases. Signs and symptoms of VHFs include (by definition) fever and increased susceptibility to bleeding (bleeding diathesis). Manifestations of VHF often also include flushing of the face and chest, small red or purple spots (petechiae), external and internal bleeding, swelling caused by edema, low blood pressure (hypotension), and shock. Malaise (feeling of bodily discomfort)  muscle pain (myalgia), headache, vomiting, and diarrhea occur frequently. It is a myth that the organs liquefy. The severity of symptoms varies with the type of virus, with the “VHF    syndrome” capillary leaks, bleeding diathesis (makes the body susceptible to certain diseases) and circulatory weakness leading to shock) appearing in a majority of patients with filovirus hemorhhagic fevers.
Different hemorrhagic fever viruses act on the body in different ways, resulting in different symptoms. In most VHFs, it is likely that several mechanisms contribute to symptoms, including liver damage, disseminated intravascular coagulation (DIC), and bone marrow dysfunction. In DIC, small blood clots form in blood vessels throughout the body, removing platelets necessary for clotting from the bloodstream and thereby reducing the clotting ability of blood. DIC causes internal bleeding in Ebola fevers.
The reasons for variation among patients infected with the same virus are unknown but the viruses stem from a complex system of virus-host interactions. Dengue fever (which causes severe pain in the head, eyes, throat, muscles and joints) becomes more virulent during a second infection by means of the weakness of antibodies that fight infections.

After the first infection, macrophages display antibodies on their cell membranes specific to the dengue virus. By attaching to these antibodies, dengue viruses from a second infection are better able to infect the macrophages, thus reducing the immune system’s ability to fight off infections.
Medical researchers have hypothesized that the first patient become infected through contact with an infected animal; probably fruit bats.  After the first case-patient in an outbreak setting was infected, the virus was transmitted in several ways.

People can be exposed to Ebola virus from direct contact with the blood and/or secretions of an infected person. Thus, the virus is often spread through families and friends because they come in close contact with such secretions when caring for infected persons. People can also be exposed to Ebola virus through contact with objects, such as needles, that have been contaminated with infected secretions. Burial ceremonies where mourners have direct contact with the body of the deceased person by washing their bodies can play a significant role in the transmission of Ebola. Nosocomial transmission refers to the spread of a disease within a health-care setting, such as a clinic or hospital. It occurs frequently during Ebola outbreaks.

After a person becomes infected with the Ebola virus, it begins to multiply within the body. On average, Ebola virus symptoms begin to appear four to six days after the person has become infected. The period between infection and the start of symptoms is called the incubation period for the virus. The Ebola incubation period can be as short as 2 days or as long as 21 days, depending on the body’s ability to fight infection.

Ebola is characterized by the sudden onset of fever, intense weakness, muscle pain, stomach pain, headache, dry hacking cough, sore throat and vomiting. This is often followed diarrhea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Some patients develop hiccups. Laboratory findings show low counts of white blood cells (which fight disease) and platelets as well as elevated liver enzymes. (proteins).

I should point out that simply because someone is suffering from one or several signs of these illnesses doesn’t necessarily mean that they are suffering from Ebola. Although that disease is contagious if someone has it and you exchange bodily fluids such as having intercourse with that person or you touch the skin of someone who is suffering from  Ebola and who is sweating, it is not likely you will catch the disease since the virus is not airborne.

Diagnosing Ebola in an individual who has been infected after only a few days is difficult because early symptoms, such as red eyes and a skin rash, are nonspecific to the virus and are seen in other patients with diseases that occur much more frequently and far less deadly. Death usually occurs during the second week of symptoms. Ebola victims typically die from massive blood loss.

Severe cases of Ebola require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes. No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several potential vaccines are being tested but it could be several years before any are available. A new drug therapy has shown some promise in laboratory studies and is currently being evaluated. There are few established primary prevention measures.

The global medical charity, Doctors Without Borders has given warning that the Ebola crisis in West Africa is "unprecedented, absolutely out of control", as states across the world take steps to prevent its spread. Bart Janssens, the charity's director of operations, warned there was no overarching vision of how to tackle the outbreak. More than 670 people have died of Ebola in the recent outbreak—the largest on record since the disease was detected in the 1970s. The outbreak began in southern Guinea and spread to Liberia, Sierra Leone and Nigeria.

At least 1,870 known deaths have been documented since the Ebola virus was discovered. Obviously there are probably many more deaths that have not been recorded.

Two medical practioners in West Africa have currently died from this disease and two others who contacted the disease have been flown to Atlanta in the US for treatment.

One really sad aspect of this disease is that some and perhaps many of the victims in West Africa who have contacted the disease are abandoned by their fellow villagers because of the fear generated by this disease. As a result, these unfortunate Ebola victims are not brought to medical centres and instead they are left to die alone in utmost agony.

As horrible as this disease is, it certainly is not the worst disease that has existed in the world. In the 14th century, the Bubonic Plague killed an estimated 25 million people—30–60% of the European population.

The 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic. It infected 500 million people across the world, including remote Pacific islands and the Arctic.  Called the Spanish Flue, it killed 50 to 100 million people—three to five percent of the world's population thereby making it one of the deadliest natural disasters in human history.

Approximately a third of the world's population is thought to have been infected with tuberculosis, (TB) with new infections occurring in about 1% of the population each year. In 2007, an estimated 13.7 million chronic cases were active globally, while in 2010, an estimated 8.8 million new cases and 1.5 million associated deaths occurred, mostly in developing countries.

In 1938, when I was a small child, I developed TB in my left lung. I was placed in a sanitarium for children suffering from TB for almost a year before the doctors decided that I had been cured. No one knew how I got it but in those times, unpasteurized milk was given to us and the TB virus was found in many cows. We had what is called “bovine tuberculosis”. Incidentally, there was no valid cure for TB then other than sunshine and lots of fresh air. We had to sleep on a wide veranda that went around three sides of the building every night, even in the winter when the temperature dropped below zero.

More than 25 million people have died of AIDS worldwide since the first cases were reported in 1988.

Malaria is a disease that is widespread in tropical and subtropical regions in a broad band around the equator, including much of Sub-Saharan Africa, Asia, and in South and Central Americas. The World Health Organization estimates that in 2010, there were 219 million documented cases of malaria. That year alone,  the disease killed between 660,000 and 1.2 million people, many of whom were children in Africa. The actual number of deaths is not known with certainty: data is unavailable in many rural areas, and many cases are undocumented. It is currently the worst communicable disease in the world.

I hope you have found this article informative and interesting even if it is a bit scary. 

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